IMAGE  EVALUATION 
TEST  TARGET  (MT-S) 


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2.0 


1.8 


U.  Illlli.6 


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Photographic 

Sciences 

Corporation 


23  WEST  MAIN  STREkT 

WEBSTER,  NY.  14580 

(716)  872-4503 


-f^       •-- 


CIHM/ICMH 

Microfiche 

Series. 


CIHIVI/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historical  Microreproductions  /  Institut  Canadian  de  microreproductions  historiques 


Technical  and  Bibliographic  Notas/Notas  tachniquaa  at  bibliographiquas 


Tha  Instituta  has  attamptad  to  obtain  tha  bast 
original  copy  availabia  for  filming.  Faaturas  of  this 
copy  which  may  ba  bibliographically  uniqua. 
which  may  altar  any  of  tha  imagas  in  tha 
reproduction,  or  which  may  significantly  change 
tha  usual  method  of  filming,  are  checked  below. 


0    Coloured  covers/ 
Couverture  de  couleur 


rr^    Covers  damaged/ 


D 
D 

n 
n 


D 


Couverture  endommag^e 

Covers  restored  and/or  laminated/ 
Couverture  restaur^  et/ou  pelliculAe 


D 


Cover  title  missing/ 

Le  titre  de  couverture  manque 

Coloured  mapa/ 

Cartes  giographiques  en  couleur 

Coloured  ink  (i.e.  other  than  blue  or  black)/ 
Encre  de  couleur  (i.e.  autre  que  bleue  ou  noirei 

Coloured  plates  and/or  illustrations/ 
Planches  et/ou  illustrations  en  couleur 

Bound  with  other  material/ 
ReliA  avac  d'autres  documents 

Tight  binding  may  cause  shadows  or  distortion 
along  interior  margin/ 

La  rs  Mure  serrde  peut  causer  de  I'ombre  ou  de  la 
distorsion  le  long  de  la  marge  intirieure 

Blank  leaves  added  during  restoration  may 
appear  within  the  text.  Whenever  possible,  these 
have  been  omitted  from  filming/ 
II  se  peut  que  certaines  pages  blanches  ajouties 
lors  d'une  restauration  apparaissent  dans  le  texte. 
mais,  lorsque  cela  Atait  possible,  ces  pages  n'ont 
pas  M  filmtes. 

Additional  comments:/ 
Commentairas  supplAmantaires; 


L'Institut  a  microfilm^  la  mailleur  examplaira 
qu'il  lui  a  iti  possible  de  se  procurer.  Las  details 
de  cet  exemplaire  qui  sont  peut-dtre  uniques  du 
point  de  vue  bibliographiqua,  qui  peuvant  modifier 
una  image  reproduite,  ou  qui  peuvent  exiger  une 
modification  dans  la  mAthode  normaia  de  filmage 
sont  indiquAs  ci-dessous. 

□   Coloured  pages/ 
Pagea  de  couleur 

□    Pages  damaged/ 
Pages  endommagdas 

□    Pages  restored  and/or  laminated/ 
Pages  restauries  et/ou  pelliculdes 

rrn    Pages  discoloured,  stained  or  foxed/ 


7 
t( 


D 


Pages  dicoiories,  tacheties  ou  piquies 

Pages  detached/ 
Pages  ditach4«s 

Showthrough/ 
Transparence 

Quality  of  prir 

Qualiti  inigale  de  I'impression 

Includes  supplementary  materic 
Comprend  du  material  supplementaire 

Only  edition  available/ 
Seule  Edition  disponible 


I      I  Pages  detached/ 

rri  Showthrough/ 

r~~|  Quality  of  print  varies/ 

r~n  Includes  supplementary  material/ 

I — I  Only  edition  available/ 


Pages  wholly  or  partially  obscured  by  errata 
slips,  tissues,  etc.,  have  been  ref limed  to 
ensure  the  best  possible  image/ 
Les  peges  totalement  ou  partieilement 
obscurcies  par  un  feuillet  d'errata,  une  pelure, 
etc.,  ont  M  filmies  d  nouveau  de  facon  A 
obtenir  la  meilleure  image  possible. 


This  item  is  filmed  at  the  reduction  ratio  checked  below/ 

Ce  document  est  filmd  au  taux  de  rMuction  indiqui  ci-dessous. 

10X  14X  18X  22X 


y 


12X 


16X 


20X 


26X 


30X 


24X 


28X 


32X 


Th«  copy  filmed  h«r«  has  be«n  raproducad  thanks 
to  tha  ganarosity  of: 

Medical  Library 
McGill  University 
Moittreal 

Tha  imagas  appaaring  hara  ara  tha  bast  quality 
possibia  conaidaring  tha  condition  and  lagibility 
of  tha  original  copy  and  in  icaaping  with  tha 
filming  contract  spacificationa. 


L'axamplaira  film4  fut  raproduit  grftca  i  la 
gin^rosit*  da: 

Medical  Library 
McGill  University 
Montreal 

Laa  imagaa  suivantaa  ont  4ti  raproduitaa  avac  la 
plua  grand  toin,  compta  tanu  da  la  condition  at 
da  la  nattat*  da  l'axamplaira  fiimA,  at  an 
conformitA  avac  laa  conditions  du  contrat  da 
filmaga. 


Original  copiaa  in  printad  papar  eovars  ara  filmad 
beginning  with  tha  front  covar  and  anding  on 
tha  last  paga  with  a  printad  or  illuatratad  impraa- 
sion,  or  tha  bactt  covar  whan  appropriate.  All 
othar  original  copiaa  ara  filmad  beginning  on  the 
first  paga  with  a  printad  or  illustrated  impree- 
sion.  and  anding  on  the  last  page  with  a  printad 
or  illustrated  impression. 


The  last  recorded  frame  on  each  microfiche 
shall  contain  the  symbol  —^(meaning  "CON- 
TINUED"), or  the  symbol  y  (meaning  "END"), 
whichever  appliaa. 

Mapa,  platea,  charts,  etc.,  may  be  filmed  at 
different  reduction  ratioa.  Thoae  too  large  to  be 
entirely  included  in  one  expoaure  ara  filmed 
beginning  in  the  upper  left  hand  comer,  left  to 
right  and  top  to  bottom,  as  many  frames  aa 
required.  The  following  diagrams  illustrate  the 
method: 


Laa  axemplairas  originsux  dont  la  couvarture  an 
papier  eat  imprimte  sont  filmte  an  commanpant 
par  la  premier  plat  at  en  tarminant  soit  par  la 
derniAre  page  qui  comporte  une  amprainte 
d'Impreeaion  ou  d'iilustration,  soit  par  la  second 
piat,  salon  la  eaa.  Tous  lee  autras  axemplairas 
originaux  sont  filmte  an  commandant  par  la 
premiere  paga  qui  comporte  une  amprainte 
dimpreaaion  ou  d'iilustration  at  9n  tarminant  par 
la  derniAre  page  qui  comporte  une  telle 
empreinte. 

Un  dee  symboiea  suivants  apparaitra  sur  l» 
demiAre  imege  de  cheque  microfirhe.  seion  le 
caa:  le  symbols  —*•  signifie  "A  SUIVRE".  le 
symbols  V  signifie  "FIN". 

Lee  cartes,  planches,  tableaux,  ate,  pauvent  dtra 
fllmte  i  dee  taux  de  rMuction  diff^rents. 
Lorsque  le  document  est  trop  grand  pour  dtre 
reproduit  en  un  seul  cliche,  ii  est  fiim^  d  partir 
de  I'angie  supArieur  gauche,  de  gauche  d  droite, 
et  de  haut  an  baa.  an  prenant  la  nombre 
d'imeges  nicassaira.  Laa  diagrammes  suivants 
iilustrent  la  m^thode. 


1  2  3 


32X 


1 

2 

3 

4 

5 

6 

TEACHER  AND  STUDENT. 


AN    ADDRESS 

Delivered  on  the  Occasion  op  the  Opening  op  the  New 
Building  op  the  College  op  Medicine  and  Sur- 

QERY   OF    THE   UNIVERSITY    OP    MINNESOTA, 

Minneapolis,  October  4th,  1892. 


BY 


WILLIAM  OSLER,  M.  D,  F.  R.  C.  P.  Lonb, 

Ftofessor  of  Medicine  in  the  Johns  Hopkins  Univer^ty  and  Phyncian^n-Chief 
to  the  Johns  Hopkins  Hospital,  Baltimore. 


BALTIMORE: 

JOHN   MURPHY  &  CO., 
1892. 


A  University  consists,  and  has  ever  consisted,  in  demand  and  supply,  in  wants  wiilch 
it  alone  can  satisfy  and  which  it  does  satisfy,  in  the  communication  of  knowledge  and 
the  relation  and  bond  which  exists  between  the  teacl,er  and  Ihe  tauRht.  Its  constituting 
an.mating  principle  is  this  moral  attraction  of  one  class  of  persons  to  another;  which  is' 
prior  in  its  nature,  nay  commonly  in  its  history,  to  any  other  tie  whatever;  so  that 
where  this  Is  wanting,  a  University  is  alive  only  in  name,  and  has  los.,  its  true  essence,' 
whatever  be  the  advantages,  whether  of  position  or  of  affluence,  with  which  the  civil 
power  or  private  benefactors  contrive  to  encircle  it.-JoiiN  Henry  Newman. 

It  would  seem,.Adeimantus,  that  the  direction  in  which  education  starts  a  man  will 
determine  his  future  life.-PLATO,  Bejmblic,  iv. 


I 


ADDRESS. 


Your  Excellency,  Mr.  Preddenf,  Ladies  and  Omtlemeri  .— 

When  I  received  from  the  Dean  of  the  College  of  Medicine, 
Dr.  MiHard,  an  invitation  to  deliver  the  opening  address  on 
this  occasion,  tiiere  were  several  reasons  lor  a  ready  acqui- 
escence.    There  was  nothing  nearly  so  good  on  hand  for  the 
first  week  of  October,  which  long  habit  had  made  for  me  the 
week  of  weeks  in  the  calendar.     Here  was  a  chance  to  satisfy 
the  '^besoin  de  respirer"  in   an   atmosphere  brightened  by 
young  lives,  to  still  a  deep  autumnal  yearning  not  unnatin-al 
in  a  man  the  best  years  of  whose  life  have  been  passed  with 
undergraduate  students,  and  who  has  had  temporarily  to  con- 
tent himself  with  the  dry  husks  of  graduate  teaching.     Then 
the  invitation  was  a  great  compliment,  greater,  for  the  distance 
It  had  travelled ;  but  lastly  and  chiefly  I  wanted  to  see  you 
all,  to  relieve  a  brotherly  instinct  such  as  sent  David  to  his 
brethren  in  the  camp  of  Saul,  an  instinct  which  has  often 
driven   me  far  afield,  and   has  enriched  my  life  with  good 
friends  and  pleasant  memories. 

Nor  did  I  hesitate  a  moment  in  the  selection  of  a  subject. 
On  such  an  occasion,  and  at  this  time,  when  the  profession 
and  public  are  awakening  to  the  importance  of  medical  edu- 
cation, my  choice  was  necessarily  restricted.  Instead,  how- 
ever, of  a  formal  presentation  of  the  conditions  and  needs  of 
medical  study,  I  shall  address  myself  chiefly  to  a  considera- 
tion of  some  of  our  functions  as  teachers,  in  dealing  with 

3 


'*  Teacher  and  Student. 

which  I  can  incidentally  touch  upon  questions  of  general 
interest,  and  can,  moreover,  speaking  on  behalf  of  the  Fac- 
ulty, say  a  few  words  of  w«>lcome  and  encouragement  to  the 
cJasaes  wJuch  have  assembled  for  the  year 


I. 

Truly  it  may  be  said  to-day  that  in  the  methods  of  teaching 
med.cne  the  old  order  changeth  giving  place  to  new,  and  to 
this  revolution  let  me  briefly  refer,  since  it  has  an  immediate 
bearing  on  the  main  point  I  wish  to  make  in  the  first  portion 
of  my  address.    The  medical  schools  of  the  countrv  have  been 
either  independent,  University,  or  State  Institutions.     The 
tirst  class,  by  far  the  most  numerous,  have  in  title  University 
affiliations,  but  are  actually  devoid  of  organic  union  with  seats 
ot  learning.     Necessary  as  these  bodies  have  been  in  the  past, 
It  IS  a  cause  for  sincere  congratulation  that  the  number  is 
steadily  diminishing.    Admirable  in  certain  respects-adorned 
too  in  many  instances  by  the  names  of  men  who  bore  the  bur- 
den and  heat  of  the  day  of  small  things  and  have  passed  to 
their  rest  amid  our  honored  dead-the  truth  must  be  acknowl- 
edged  that  the  lamentable  state  of  medical  education  in  this 
country  twenty  years  ago  was  the  direct  result  of  the  inherent 
viciousness  of  a  system  they   fostered.      Something  in   the 
scheme  gradually  dea.lened  in  the  professors  all  sense  of  re- 
sponsibility until  they  professed  to  teach  (mark   the  word) 
in  less  than  two  years— one  of  the  most  difficult  arts  in  the 
world  to  acquire.     Responsibility!    fellow  teachers  in  medi- 
cine, believe  me  that  when  in  the  next  century  some  historian, 
standing  perhaps  in  this  place,  traces  the  development  of  the 
profession  in  this  country,  he  will  dwell  on  notable  achieve- 
ments, on  great  discoveries,  and  on  the  unwearied  devotion  of 
Its  members,  but  he  will  pass  judgment— yes,  severe  judgment 
-on  the  absence  of  the  sense  of  responsibility  which  permitted 
a  criminal  laxity  in  medical  education  unknown  before  in  our 
annals.     But  an  awakening  has  come,  and  there  is  sounding 


Teacher  and  Student.  5 

tlio  knell  of  the  doom  of  the  medical  college,  responsible  neither 
to  the  public  nor  the  profession. 

The  schools  with  close  university  connections  have  been  the 
most  progressive  and  thorough  in  this  country.  The  revolu- 
tion referred  to  began  some  twenty  years  ago  by  the  appear- 
ance of  the  President  of  a  well  known  University  at  a  meeting 
of  Its  medical  faculty  with  a  peremptory  command  to  set  their 
house  in  order.  Universities  which  teach  only  the  Liberal 
Arts  remain  to-day,  as  in  the  middle  ages,  Schohe  minores, 
laeking  the  technical  faculties  which  make  the  Schohe  majores. 
The  advantages  of  this  most  natural  union  are  manifold  and 
reciprocal.  The  professors  in  a  University  medical  school 
have  not  that  independence  of  which  I  have  spoken,  but  are 
under  an  influence  which  tends  constantly  to  keep  them  at  a 
high  level,  and  the  spirit  of  emulation  with  the  other  faculties 
improves  the  standard  of  work,  and  is  a  strong  stimulus  to 
further  development. 

To  anyone  who  has  watched  the  growth  of  the  new  ideas 
in  education  it  is  evident  that  the  most  solid  advances  in 
methods  of  teaching,  the  improved  equipment,  clinical  and 
laboratory,  and  the  kindlier  spirit  of  generous  rivalry— which 
formerly  consisted  in  that  debased  counting  of  heads  as  a  test 
of  merit— all  these  advantages  have  come  from  a  tightening 
of  the  bonds  between  the  medical  school  and  the  University. 
And  lastly  there  are  the  State  schools,  of  which  this  college 
IS  one  of  the  few  examples.     It  has  been  a  characteristic  of 
American  Institutions  to  foster  private  industries  and  to  per- 
mit private  corporations  to  meet  any  demands  on  the  part  of 
the  public.     This  idea  carried  to  extreme  allowed  the  unre- 
stricted manufacture— note  the  term— of  doctors,  quite  regard- 
less of  the  qualifications  usually  though  necessary  in  civilized 
communities— of  physicians  who  may  never  have  been  inside 
a  hospital  ward,  and  who  had  after  graduation  to  learn  medi- 
cine somewhat  in   the  fashion  of  the  Chinese  doctors  who 
recognized  the  course  of  the  arteries  of  the  body,  by  noting 
just  where  the  blood  spurted  when  the  acupuncture  needle 


Teacher  and  Student. 


was  inHcrtod.     So  far  an  I  know  State  authorities  luivc  iiev(.'r 
interfered  with  any  lct,'ally  instituted  tnedi(!al  sehool,  however 
poorly  equipped   fbr  its  work,  however  lax  the  (pialificiitions 
for  lieense.     Not  only   has  this  policy  of  non-intervention 
been  carried  to  excess,  hut  in  many  states  a  few  phvsi(rians  of 
any  town  coidd  get  a  charter  for  a  school  without  giving 
guarantees   that    laboratory    or   clinical    facilities    would    be 
available.      This  anoniiilous  condition   is  rapidly  changing, 
owing  partly  to  a  revival  of  loyalty  to  higher  ideals  w?thin' 
our   ranks,    and    partly   to  a  growing   appreciation    in    the 
public  of  the   value  of  physicians  thoroughly   educated   in 
modern    methods.     A   j)ractical    acknowledgment  of  this  is 
found  in  the  recognition  in  three  States  at  least  of  medicine 
as  one  of  the  technical  branches  to  be  taught  in  the  Univer- 
sity supported  by  the  people  at  large. 

But  it  is  a  secondary  matter,  after  all,  whether  a  school  is 
under  state  or  University  control,  whether  the  endowments 
are  great  or  small,  the  eqiu'pments  palatial  or  liumbh.',  the 
fate  of  an  institution  rests  not  on  these;  the  inherent,  vital 
element,  which  transcends  all  material  interests,  which  may 
give  to  a  school  glory  and   renown   in   their  absence    and 
lacking  which  all  the  "  pride,  pomp  ami  circumstance'"  are 
vam— this   vitalizing  element,  I  say,  lies  in  the  men  who 
work  in  its  halls,  and  in  the  ideals  which  they  cherish  and 
teach.     There  is  a  passage  in  one  of  John  Henry  Newman's 
Historical  Sketcihes,  which  expresses  this  feeling  in  terse  and 
beautiful  language,  "  I  say  then  that  the  personality  of  the 
teacher  is  able  in  some  sort  to  dispense  with  an  academical 
system,  but  that  the  system  cannot  in  any  way  disi)ense  with 
personal  influence.     With  influence  there  is  life,  without  it 
there  is  none;  if  influence  is  deprived  of  its  true  position  it 
wdl  not  by  those  means  be  got  rid  of,  it  will  on Iv  break  out 
irregularly,  dangerously.     An  academical  system  without  the 
personal  influence  of  teachers  upon  pupils  is  an  Arctic  winter  • 
It  wdl  create  an  ice-bound,  petrified,  cast-iron  University,  and 
nothing  else." 


Teacher  and  Strident.  f 

Naturally  from  this  standpoint  the  selection  of  teachers  is 
the  function  of  the  highest  importance  in  the  Regents  of  a 
University.     Owing  to  local  conditions  the  choice  of  men  for 
certain  of  the  chairs  is  restrictal  to  residents  in  the  University 
town,  as  the  salaries  in  most  schools  of  this  country  have  to 
be  supplemented  by  outside  work.     But  in  all  departments 
this  principle  should   be  acknowledged   and  acted  upon  by 
trustees  and  faculties,  and  supported  by  public  opinion— that 
the  very  best  men  available  should  receive  appointments.     It 
is  gratifying  to  note  the  broad  liberality  displayed  by  American 
colleges  in  welcoming  from  all  parts  teachers  who  may  have 
shown  any  special  fitness,  emulating  in  this  respect  the  liber- 
ality of  the  AtheniaJis,  in  whose  porticoes  and  lecture  halls 
the  stranger  was  greeted  as  a  citizen  and  judged  by  his  mental 
gifts  alone.     Not  the  least  by  any  means  of  the  o'  ;ect  lessons 
taught  by  a  great  University  is  that  literature  and   science 
know  no  country,  and,  as  has  been  well  said,  acknowledge  '  no 
sovereignty  but  that  of  mind,  and  no  nobility  but  that  of 
genius.'     But  it   is  difficult  in  this  matter  to  guide  public 
opinion  and  the  Regents  have  often  to  combat,  and  meet  with 
firmness,  a  provincialism  which   is  as   fatal   to  the  highest 
development  of  a  University  as  is  the  shibboleth  of  a  sec- 
tarian institution.     No  taint  of  this  vice  is  here  apparent,  nor 
does  it  appear  in  your  sister  State  Universities,  which  have 
medical  faculties.     Michigan  has  displayed  a  notable  freedom 
from  this  spirit  in  the  appointments  to  chairs  in  the  medical 
faculty,  and,  if  I  remember  aright,  the  last  three  nominations 
were  from  London,  Philadelphia,  and  Galveston.'     So  also 
in  the  newly  organized  medical  faculty  of  the  State  Univer- 
sity of  Texas,  a  wide  freedom  of  choice  was  shown  and  the 
best  men  were  chosen,  irresi)ective  of  race  or  country. 


»  And  not  only  in  this  respect  is  Michigan  an  example.  She  has  earned 
the  gratitude  of  every  lover  of  higher  education  by  first  making  compulsory 
a  four-year  curriculum.  Harvard  has  followed  this  session,  and  the  Uni- 
versity  of  Pennsylvania  begins  next  year.  We  now  have  first,  second  and 
third  class  schools,  corresponding  to  the  four,  three  and  two  session  colleges. 


8 


Teacher  and  Student. 


II. 

The  function  of  the  teacher,  to  paraphrase  the  words  of 
Matthew  Arnold,  is  to  teacii  and  to  propagate  the  best  that  is 
knovvn  and  taugln  in  the  world.  To  teach  the  ciirre.it  knowl- 
edge of  the  subject  he  professes— sifting,  analyzing,  assortmg, 
laying  down  principles.  To  propagate ;  /.  'e.,  to  mult4)ly, 
facts  on  \yhich  to  base  principles— experimenting,  searching, 
testing.  The  best  that  is  known  and  taught  in  the  world- 
nothing  less  can  satisfy  a  teacher  worthy  of  the  name,  and 
upon  us  of  the  medical  faculty  lies  a  bounden  duty  in  this 
respect,  since  our  Art,  coordinate  with  human  suffering,  is  cos- 
mopolitan. 

There  are  two  aspects  in  which  we  may  view  the  teacher,  as  a 
worker  and  instructor  in  science,  and  as  practitioner  and  pro- 
fessor of  the  art;  and  these  correspond  to  the  natural  division 
of  the  faculty  into  the  medical  school  proper  and  the  hospital. 

In  this  eminently  practical  country  the  teacher  of  science 
has  not  yet  received  full  recognition,  owing  in  part  to  the 
great  expense  connected  with  his  work,  and  in  part  to  care- 
lessness or  ignorance  in  the  public  as  to  the  real  strength  of 
a  nation.     To  equip  and  maintain  separate  Laboratories  in 
Anatomy,  Physiology,  Chemistry  (physiological  and  pharma- 
cological), Pathology  and  Hygiene,  to  employ  skilled  teach- 
ers, who  shall  spend  all  their  time  in  study  and  instruction, 
requires  a  capital  not  to-day  at  the  command  of  any  medical 
school  in  the  land.    There  are  fortunate  ones  with  two  or  three 
departments  well  organized,  not  one  with  all.     In  contrast, 
Bavaria,  a  kingdom  of  the  German  Empire,  with  an  area  less 
than  this  state,  and  a  population  of  five  and  a  half  millions, 
supports  in  its  three  University  towns  flourishing   medical 
schools  with  extensive  laboratories,  many  of  wnich  are  presided 
over  by  men  of  world-wide  reputation,  the  steps  of  whose  doors 
are  worn  in  many  cases  by  (!is-Atlantic  students  seeking  the  wis- 
dom of  methods  and  the  virtue  of  inspiration  not  easily  acces- 
sible at  home.    But  there  were  professors  in  Bavaiian  medical 


TeacJier  and  Student.  9 

schools  before  Marquette  and  Joliet  had  launched  their  canoes 
on  the  great  sirea.n  which  the  intrepid  La  Salle  had  discovered 
before  Du  Luth  met  Father  Hennepin  below  the  falls  of  St 
Anthoiiy ;  and  justice  compels  us  to  acknowledge  that  in  the 
winuing  of  an  empire  from  the  back-woods  the  people  of  this 
land  had  other  things  to  think  of,  more  urgent  needs  tlian  labo- 
ratories of  research.    AH  has  now  changed.    In  this  state  for 
example,  the  phenomenal  growth  of  which  has  repeat-d'the 
growth  of  the  nation,  the  wilderness  has  been  made  to  blossom 
as  the  rose,  and  tlic  evidences  of  wealth  and  prosperity  on 
every  side  almost  constrains  one  to  break  out  into  the 'now 
old  song,  "ITappy  is  that  people  that  is  in  such  a  case." 
_    But  in  the  enormous  development  of  material  interests  there 
IS  danger  lest  we  miss  altogether  the  secret  of  a  nation's  life  " 
the  true  test  of  which  is  to  be  found  in  its  i.itellectual  and 
moral  standards.     There  is  no  more  potent  antidote  to  the 
corrodmg  mfluence  of  mammon  than  the  presence  in  a  com- 
munity of  a  body  of  men  devoted  to  science,  living  for  inves- 
tigation, and  earing  nothing  for  the  lust  of  the  eyes  and  the 
pride  of  life.     We  forget  that  the  measure  of  the'  value  of  a 
nation  to  the  world  is  neither  the  bushel  nor  the  barrel    but 
mmd;  and  that  wheat  and  pork,  though  useful  and  necessary 
are  but  dross  m  comparison  with  intellectual  products  which 
alone  are  imperishable.     The  kindly  fruits  of  the  earth  are 
easily  grown ;  the  finer  fruits  of  the  mind  are  of  slow  growth 
and  require  prolonged  culture.  ' 

Each  one  of  the  scientific  branches  to  which  I  have  referred 
has  been  so  specialized  that  even  to  teach  it  takes  more  time 
than  can  be  given  by  a  single  Professor,  and  the  laboratory 
classes  demand  skilled  assistance.  The  aim  of  a  school  should 
be  to  have  these  departmonts  in  the  charge  of  men  who  have  • 
first,  enthmiasm,  that  deep  love  of  a  subject,  that  desire  to 
teach  and  extend  it,  without  which  all  instruction  becomes 
cold  and  lifeless;  second,  a  full  petsonal  knowledge  of  the 
branch  taught,  not  a  second-hand  information  derived  from 
books,  but  the  living  experience  derived  from  experimental 


10 


Teacher  and  Student. 


and  practical  work   in  the  best  laboratories.     This  type  of 
instructor  is  fortunately  not  rare  in  American  schools.     The 
well-grounded  students  who  have  pursued   their  studies  in 
England  and  on  the  Continent  have  added  depth  and  breadth 
to  our  professional  scholarship,  and  their  critical  faculties  have 
been  sharpened  to  discern  what  is  best  in  the  world  of  medi- 
cine. ^  It  is  particularly  in  these  branches  that  we  need  teachers 
of  wide  learning,  whose  standards  of  work  are  the  highest 
known,  and  whose  methods  are  those  of  the  masters  in  Israel. 
Third,  men  who  have  a  seme  of  obligation,  that  feeling  which 
impels  a  teacher  to  be  also  a  contributor,  and  to  add  to  the 
stores  from  which  he  so  freely  draws.     And  precisely  here 
is  the  necessity  to  know  the  best  that  is  taught  in  his  branch, 
the  world  over.     The  investigator  to  be  successful  must  start 
abreast  of  the  knowledge  of  the  day,  and  he  differs  from  the 
teacher,  who,  living  in  the  present,  expounds  only  what  is 
current,  in  that  his  thoughts  must  be  in  the  future,  and  his 
ways  and  work  in  advance  of  the  day  in  which   he  lives. 
Thus,  unless  a  bacteriologist  has  studiaJ  methods  thoroughly 
and  is  familiar  with  the  extraordinarily  complex  flora  associ- 
ated with  healthy  and  diseased  conditions,  and  keeps  in  touch 
with  every  laboratory  of  research  at  home  and  abroad,  he  will, 
in  attempting  original  work,  find  himself  exploring  ground 
already  well   known,  and  will  probably  burden  an   already 
over-laden  literature  with  faulty  and  crude  observations.     To 
avoid  mistakes  he  must  know  what  is  going  on  in  the  labora- 
tories of  England,  France,  and  Germany,  as  well  as  in  those 
of  his  own  country,  and  he  must  receive  and  read  six  or  ten 
journals  devoted  to  the  subject.     The  same  need  for  wide  and 
accurate  study  holds  good  in  all  branches. 

Thoroughly  equipped  laboratories  in  charge  of  men  thoroughly 
equipped  as  teachers  and  investigators  is  the  most  pressing  loant 
to-day  in  the  medical  schools  of  this  country. 

The  teacher  as  a  professor  and  practitioner  of  his  art  is 
more  favored  than  his  brother,  of  whom  I  have  been  speaking ; 
he  is  more  common,  too,  and  less  interesting ;  though  in  the 


Teacher  and  Student. 


11 


eyes  of  "the  fooj   multitude  who  choose   by  show"  more 
important.     And  from  the  standpoint  of  medicine  as  an  art 
for  the  prevention  and  cure  of  disease,  the  man  who  translates 
the  hieroglyphics  of  science  into  the  plain  language  of  healing 
IS  certainly  the  more  useful.     He  is  more  favored  in  as  much 
as  the  laboratory  in  which  he  works,  the  hospital,  is  a  neces- 
sity ,n  every  centre  of  population.     The  same  obligation  rests 
on  him  to  know  and  to  teach   the  best  that  is  known  and 
taught  in  the  world— on  the  surgeon  the  obligation  to  know 
thorougiily  the  scientific  principles  on  which  iiis  art  is  based 
to  be  a  master  in  the  technique  of  his  handicraft,  ever  study- 
ing, modifying,  improving  ;-on  the  physician,  the  obligation 
to  study  the  natural   history  of  diseases  and  the  means  for 
their  prevention,  to  know  the  true  value  of  regimen,  diet,  and 
drugs  in  their  treatment,  ever  testing,  devising,  thinking.— 
and  upon  both,  to  teach  to  their  students  habits  of  self-reliance 
and  to  be  to  them  examples  of  gentleness,  forbearance,  and 
courtesy  in  dealing  with  their  suffering  brethren. 

I  would  fain  dwell  upon  many  other  points  in  the  relation 
of  the  hospital  to  the  medical  school— on  the  necessitv  of 
ample,  full  and  prolonged  clinical  instruction,  and  the  import- 
ance of  bringing  the  student  and  the  patient  into  close  con- 
tact; not  the  cloudy  knowledge  of  the  amphitheatre,  but  the 
accurate,  critical  knowledge  of  the  wards;  on  the  encourage- 
ment of  the  younger  men  as  instructors  and  helpers  in  ward 
work  and  upon  the  duty  of  hospital  physicians  and  surc^eons 
to  contribute  to  the  advance  of  their  art— but  I  pass  on^with 
an  illusion  to  a  very  delicate  matter  in  college  faculties. 

From  one  who,  like  themselves,  has  passed  la  crise  d'e  qunr- 
ante  am,  the  seniors  present  will  pardon  a  few  plain  remarks 
upon  the  disadvantages  to  a  school  of  having  too  many  men 
of  mature,  not  to  say,  riper  years.  Insensibly  in  the  fifth  and 
sixth  decades  there  begins  to  creep  over  most  of  us  a  change 
noted  physically  among  other  ways  in  the  silvering  of  the  hair 
and  that  lessoning  of  elasticity,  which  impels  a  man  to  open 
rather  than  to  vault  a  five-barred  gate.    It  comes  to  all  sooner 


12 


Teacher  and  Stiidetit. 


or  later,  to  some  only  too  painfully  evident,  to  others  nncon- 
seionsly,  with  no  pace  perceived.  And  with  most  of  lis  tiiis 
physical  change  has  its  mental  equivalent,  not  necessarily 
accompanied  by  loss  of  the  powers  of  application  or  of  judg- 
ment;  on  the  contrary,  often  the  mind  grows  clearer  and  the 
memory  more  retentive,  but  the  change  is  seen  in  a  weakened 
receptivity  and  in  an  inal)ility  to  adapt  oneself  to  an  altered 
intellectual  environment.  Tt  is  this  loss  of  mental  elasticity 
which  makes  men  over  forty  so  slow  to  receive  new  trutiis. 
Harvey  complained  in  his  day  that  few  men  above  this  critical 
age  seemed  able  to  accept  the  doctrine  of  the  circulation  of  the 
blood,  and  in  our  own  time  it  is  interesting  to  note  how  the 
theory  of  the  bacterial  origin  of  certain  diseases  has  had  as 
other  truths  to  grow  t^  acceptance  with  the  generation  in 
which  it  was  announced.  The  only  safeguard  in  the  teacher 
against  this  lamentable  condition  is  to  live  in,  and  with  the 
third  decade,  in  company  with  the  younger,  more  receptive, 
and  j)rogressive  minds. 

There  is  no  sadder  picture  than  the  Professor  who  has  out- 
grown his  usefulness,  and,  the  only  one  unconscious  of  the  fact, 
insists,  with  a  praiseworthy  zeal,  upon  the  performance  of  duties 
for  which  the  circumstances  of  the  time  have  rendered  him 
unfit.  When  a  man  nor  wax  nor  honey  can  brinu-  home,  he 
should,  in  the  interests  of  an  institution,  be  dissolved  from 
the  hive  to  give  more  laborers  room  ;  though  it  is  not  every 
teacher  who  will  echo  the  sentiment 


"  Let  me  not  live  .... 
After  my  flame  lacks  oil  to  be  the  snuff 
Of  younger  spirits  whose  apprehensive  senses 
All  but  new  things  disdain." 

As  we  travel  farther  from  the  East  our  salvation  lies  in  keep- 
ing our  faces  towards  the  rising  sun,  and  in  letting  the  fates  drag 
us,  like  Cacus  his  oxen,  backwards  into  the  cave  of  oblivion. 

And  let  me  conclude  this  portion  of  my  address  with  a  few 
practical  observations.    It  is  useless  to  disguise  from  the  public 


Teacher  and  Student. 


13 


or  ourselves  that  a  first  class  medical  school  well  equipped  in  all 
details,  is  an  enormously  expensive  affair;  but  in  this  State,  and 
with  a  population  of  nearly  half'a  million  centered  in  and  about 
this  twin-city,  you  can  look  forward  with  confidence  to  a  con- 
summation of  your  utmost  hopes.     Let  me  indicate  how  much 
you  will  require  from  the  State  or  your  friends— or  both— dur- 
ing the  next  twenty-five  years.   Six  laboratories  in  the  scientific 
branches  with  the  necessary  apparatus  will  cost  not  less  than 
$200,000.    Radiating  from  a  central  building,  which  contains 
the  general  lecture  room,  library  and  museum,  they  would  be 
less  expensive  than  separate  Institutes,  as  in  the  German  Uni- 
versities.    To  provide  salaries  for  the  men  in  charge— men 
who  know  the  best  that  is  known  and  taught  in  the  world- 
will  take,  with  students'  fees,  between  four  and  five  hundred 
thousand  dollars,  paying  at  the  rate  of  from   four  to  five 
thousand  dollars  a  year.    The  hospital  department  must  be  in 
proportion,  and  in  modern  operating  rooms,  separate  pavilion 
wards  and  clinical  laboratories  another  two  hundred  thousand 
dollars  may  be  spent.     Were  I  asked  what  should  be  the  cost 
of  the  equipment  of  a  first-class,  modern,  medical  school,  one 
of  a  kind  such  as  exists  in  half  a  dozen  German  towns,  (any 
one  of  which  would  go  in  a  ward  of  this  city),  I  would  say 
one  million  dollars— not  less,  and  perhaps  a  little  more. 

Where  now  shall  we  look  for  those  liberal  endowments? 
Can  we  reasonably  expect  them  for  the  medical  schools  of  this 
country  ?    Yes,  the  flowing  tide,  so  long  with  the  Arts  and  with 
Theology,  is  with  us.    It  is  a  cheery  indication  here  that  State 
suj)port  has  not  paralyzed  private  beneficence,  and  that  some 
of  your  wealthy  men  recognize  among  the  pleasures  of  life  the 
blessedness  of  giving.    May  many  more  learn  the  secret  of  the 
only  way  to  perpetuate  a  name  in  this  country  !    Senatorships 
are  not  hereditary,  and  it  is  notorious  that  great  wealth  cannot 
stand  the  pace  of  the  third  generation.     There  is  a  serious 
danger,  too,  that  in  the  Democracy  of  the  future  the  general 
average  'vM  be  so  high  that  oblivion  will  cover  all  but  a 
chosen  few,  d  poet  here  and  there,  '  born  for  the  Universe,' 


14 


leacher  and  Student, 


and  the  capitalists,  who,  like  Johns  Hopkins  and  Cornell, 
have  linked  their  names  with  the  imperishable  things  — 
names  which  in  the  centuries  to  come  may  attain  the  sweet 
savor  of  sanctity  which  to-day  lingers  on  the  tongue  as  we 
utter  the  words  Harvard  and  Yale. 


III. 

Students  of  Medicine,  Children  of  the  Guild,  with  whom 
are  the  promises,  and  in  whom  centre  our  hopes — let  me  con- 
gratulate you  on  the  choice  of  a  calling  which  offers  a  com- 
bination of  intellectual  and  moral  interests  found  in  no  other 
profession,  and  not  met  with  at  all  in  the  common  pursuits  of 
life — a  combination  which,  in  the  words  of  Sir  James  Paget, 
"  offers  the  most  complete  and  (ionstant  union  of  those  three 
qualities  which  have  the  greatest  charm  for  pure  and  active 
minds — novelty,  utility,  and  charity."  But  I  am  not  here 
to  laud  our  profession ;  your  presence  on  these  benches  is  a 
guarantee  that  such  praise  is  superfluous.  Rather  allow  me, 
in  the  time  remaining  at  my  disposal,  to  talk  of  the  factors 
which  may  make  you  good  students — now  in  the  days  of  your 
pupilage,  and  hereafter  when  you  enter  upon  the  more  serious 
studies  in  which  the  physician  finds  himself  engaged. 

In  the  first  place  acquire  early  the  Art  of  Detachment,  by 
which  I  mean  the  faculty  of  isolating  yourselves  from  the 
pursuits  and  pleasures  incident  to  youth.  By  nature  man  is 
the  incarnation  of  idleness,  which  quality  alone,  amid  the 
ruined  remnants  of  Edenic  characters,  remains  in  all  its 
primitive  intensity.  Occasionally  we  do  find  an  individual 
who  takes  to  toil  as  others  to  pleasure,  but  the  majority  of  us 
have  to  wrestle  hard  with  the  original  Adam,  and  find  it  no 
easy  matter  to  scorn  delights  and  live  laborious  days.  Of 
special  importance  is  this  gift  to  those  of  you  who  reside  for 
the  first  time  in  a  large  city,  the  many  attractions  of  which 
offer  a  serious  obstacle  to  its  acquisition.  The  discipline 
necessary  to  secure  this  art  brings  in  its  train  habits  of  self- 


Teacher  and  Student. 


16 


control   and   forms  a  valuable   introduction   to   the  sterner 
duties  of  life. 

I  need  scarcely  warn  you  against  too  close  attention  to  your 
studies.  I  have  yet  to  meet  a  medical  student,  the  hey-dey 
in  whose  blood  had  been  quite  tamed  in  his  college  days ; 
but  if  you  think  I  have  placed  too  much  stress  upon  isolation 
in  putting  the  Art  of  Detachment  first  in  order  among  the 
desiderata  let  me  temper  the  hard  saying  by  telling  you  how 
with  "labors  assiduous  due  pleasure  to  mix."  Ask  of  any 
active  business  man  or  a  leader  in  a  profession  the  secret 
which  enables  him  to  accomplish  much  work,  and  he  will 
reply  in  one  word,  system ;  or  as  I  shall  term  it,  the  Virtue 
of  Method,  the  harness  without  which  only  the  horses  of 
genius  travel.  There  are  two  aspects  of  this  subject ;  the  first 
relates  to  the  orderly  arrangement  of  your  work,  which  is  to 
some  extent  enforced  by  the  roster  of  demonstrations  and  lec- 
tures, but  this  you  would  do  well  to  supplement  in  private 
study  by  a  schedule  in  which  each  hour  finds  its  allotted 
duty.  Thus  faithfully  followed  day  by  day  system  may 
become  at  last  engrained  in  tiie  most  shiftless  nature,  and  at 
the  end  of  a  semester  a  youth  of  moderate  ability  may  find 
himself  far  in  advance  of  the  student  who  works  spasmodi- 
cally, and  trusts  to  cramming.  4fPriceless  as  this  virtue  is 
now  in  the  time  of  your  probation  it  becomes  in  the  practising 
physician  an  incalculable  blessing.  The  incessant  and  irregular 
demands  upon  a  busy  doctor  make  it  very  difficult  to  retain, 
but  the  public  in  this  matter  can  be  educated,  and  the  men 
who  practise  with  system,  allotting  a  definite  time  of  the  day 
to  certain  work,  accomplish  much  more  and  have  at  any  rate 
a  little  leisure ;  wiiile  those  who  are  unmethodical  never  catch 
up  with  the  day's  duties  and  worry  themselves,  their  confreres, 
and  their  patients.  In  one  respect,  too,  the  unsystematic 
physician  is  absolutely  criminal.  By  the  great  law  of  con- 
traries there  is  sure  to  be  assigned  to  him  to  wife  some  gentle 
creature  to  whom  order  is  the  supreme  law,  whose  life  is 
rendered  miserable  by  the  vagaries  of  a  naan,  the  dining-room 


16 


Teacher  and  Student. 


table  in  whose  house  is  never  "cleared,"  and  who  would  an 
he  could  -breakfast  at  five  o'clock  tea  and  dine  on  the 
lollowing  day." 

The  other  aspect  of  method  has  a  deeper  significance,  hard 
for  you  to  reach,  not  consoling  when  attained,  since  it  lays 
bare  our  weaknesses.     The  practice  of  medicine  is  an  art,  based 
on  science.     Working  in  science,  with  science,  for  science,  it 
has  not  reached,  perhaps  never  will,  the  dignity  of  a  conn,Iete 
science  like  astronomy  or  engineering,  with  exact  laws.     Is 
there  then  no  science  of  medicine?     Yes,  but  in  parts  only 
such    as   anatomy   and    physiology,   and    the  extraordinary 
develoi,ment  of  these  branches  during  the  present  century 
has  been  due  to  the  cultivation  of  method,  by  which  we  have 
reached   some  degree  of  exactness,  some  certainty  of  truth 
llius  we  can  weigh  the  secretions  in  the  balance  and  measure 
the  ^^  ork  of  the  heart  in  foot-pounds.     The  deep  secrets  o^ 
generation  have  been  revealed  and  the  sesame  of  evolution 
has  given  us  fairy  tales  of  science  more  enchanting  than  the 
Arabian  Nights  entertainment.     With  this  great  increase  in 
our  knowledge  of  the  laws  governing  the  processes  of  life 
has  been  a  corresponding,  not  less  remarkable,  advance  in  all 
that  relates  to  life  in  disorder,  that  is,  disease.     The  mysteries 
ot  lieredity  are  less  mysterious,  the  operating  room  has  been 
twice  over  robbed  of  its  terrors;  the  laws  of  epidemics  are 
known   and  the  miracle  of  the  threshing  floor  of  Araunah 
the  Jebusite,  may  be  repeated  in  any  town  out  of  Bumbledom' 
All  this  change  has  come  about  by  the  observation  of  facts 
by  their  classification,  and  by  the  founding  upon  them  of 
general  laws.     Emulating  the  persistence  and  care  of  Darwin 
we  must  collect  facts  with  open-minded  watchfulness,  unbiassed 
by  crotchets  or  notions ;    fact  on  fact,  instance  on  instance 
experiment  on  experiment,  facts  which  fitly  joined  together 
by  some  master  who  grasps  the  idea  of  their  relationship  may 
establish  a  general  principle.     But  in  the  practice  of  medi- 
cine, where  our  strength  should  be  lies  our  great  weakness. 
Uur  study  is  man,  as  the  subject  of  accidents  and  diseases 


Teacher  and  Student. 


17 


Were  he  always,  inside  and  outside,  cast  in  the  same  mould, 
instead  of  differing  from  his  fellow  man  as  much  in  constitu- 
tion and  in  his  reaction  to  stimuli  as  in  feature,  we  should  ere 
this  have  reach  some  settled  principles  in  our  art.     And  not 
only  are  the  reactions  themselves  variable,  but  we,  the  doctors, 
are  so  fallible,  ever  beset  with  the  common  and  fatal  facility 
orf  reaching  conclusions  from  superficial  observations,  and  con- 
stantly misled  by  the  ease  with  which  our  minds  fall  into  the 
rut  of  one  or  two  experiences. 
H    And  thirdly  add  to  the  Virtue  of  Method,  the  Quality  of 
Thoroughness,  an  element  of  such   importance  that  I  had 
thought  of  making  it  the  only  subject  of  my  remarks.    Unfor- 
tunately, in  the  present  arrangement  of  the  curriculum,  few  of 
you  as  students  can  hope  to  obtain  more  than  a  measure  of  it, 
but  all  can  learn  its  value  now,  and  ultimately  with  patience 
become  living  examples  of  its  benefit.     Let  me  tell  you  briefly 
what  it  means.     A  knowledge  of  the  fundameutal  sciences 
upon  which  our  art  is  based— chemistry,  anatomy,  and  physi- 
ology—not a  smattering,  but  a  full  and  deep  acquaintance, 
not  with  all  the  facts,  that  is  impossible,  but  with  the  great 
principles  based  upon  them.    You  should,  as  students,  become 
familiar  with  the  methods  by  which  advances  in  knowledge 
are  made,  and  in  the  laboratory  see  clearly  the  paths  the  great 
masters  have  trodden,  though  you  yourselves  cannot  walk 
therein.     With  a  good  preliminary  training  and  a  due  appor- 
tioning of  time  you  can  reach  in  these  three  essential  studies 
a  degree  of  accuracy  which  is  the  true  preparation  for  your 
life  duties.     It  means  such  a  knowledge  of  diseases  and  of 
the  emergencies  of  life  and  of  the  means  for  their  alleviation, 
that  you  are  safe  and  trustworthy  guides  for  your  fellow-men! 
You  caimot  of  course  in  the  brief  years  of  pupilage  so  grasp 
the  details  of  the  various  branches  that  you  can  surely  recog- 
nize and  successfully  treat  all  cases.     But  here  if  you  have 
mastered   certain    principles   is  at   any  rate   one    benefit   of 
thoroughness— you  will  avoid  the  sloughs  of  charlatanism. 
Napoleon,  according  to  Sainte  Beuve,  one  day  said  when 
2 


18 


Teacher  and  Student. 


somebody  was  spoken   of  in   his   presence   as  a  charlatan, 
"Charkitan  as  much  as  you  please  but  where  is  there  not 
charlatanism  ?  "     Now  thoroughness  is  the  sole  preventive  of 
this  widespread  malady,  which  in  medicine  is  not  met  with 
only  outside  of  the  profession.     Matthew  Arnold,  who  quotes 
the  above  from  Sainte  Jieuve,  deiines  charlatanism  as  the 
"confusing  or  obliterating  the  distinctions  between  excellent 
and  inferior,  sound  and  unsound  or  only  half  sound,  true  and 
untrue  or  only  half  true."     The  higher  the  standard  of  educa- 
tion in  a  profession  the  less  marked  will  be  the  charlatanism, 
whereas  no  greater  incentive  to  its  development  can  be  found 
than  in  sending  out  from  our  colleges  men  who  have  not  had 
mental  training  sufficient  to  enable  them  to  judge  between  the 
excellent  and  the  inferior,  the  sound  and  the  unsound,  the  true 
and  the  half  true.     And  if  we  of  the  household  are  not  free 
from  the  seductions  of  this  vice,  what  of  the  people  among 
whom  we  work  ?     From  the  days  of  the  sage  of  Endor,  even 
the  rulers  have  loved  to  dabble  in  it,  while  the  public  of  all 
ages  have  ever  revelled  in  its  methods — to-day,  as  in  the  time 
of  the  Father  of  Medicine,  one  of  whose  contemporaries  (Plato) 
thus  sketc;hes  this  world-old  trait ;  "  And  what  a  delightful 
life  they  lead  !  they  are  ah /ays  doctoring  and  increasing  and 
complicating  their  disorders  and  always  fancying  that  they  will 
be  cured  by  any  nostrum  which  anybody  advises  them  to  try." 
^      The  Art  of  Detachment,  the  Virtue  of  Method,  and  the 
Quality  of  Thoroughness  may  make  you  students,  in  the  true 
sense  of  the  word,  successful   practitioners,  or  even  great 
investigators ;  but  your  characters  may  still  lack  that  which 
can  alone  give  permanence  to  powers — the  Gh-ace  of  Humility. 
As  the  divine  Italian  at  the  very  entrance  to  Purgatory  was 
led  by  his  gentle  Master  to  the  banks  of  the  island  and  girt 
with  a  rush,  indicating  thereby  that  he  had  cast  off  all  pride 
and  self-conceit,  and  was  thus  prepared  for  his  perilous  ascent 
to  the  realms  above,  so  should  you,  now  at  the  outset  of  your 
journey  take  the  reed  of  humility  in  your  hands,  in  token 
that  you  appreciate  the  length  of  the  way,  the  difficulties  to 


Teacher  and  Student. 


19 


be  overcome,  and  the  fallibility  of  the  faculties  upon  which 
you  depend. 

In  these  days  of  aggressive  self-assertion,  when  the  stress 
of  competition  is  so  keen  and  the  desire  to  make  the  most  of 
oneself  so  widespread,  it  may  seem  a  little  old-fashioned  to 
preach  the  necessity  of  this  virtue,  but  I  insist  for  its  own 
sake,  and  for  the  sake  of  what  it  brings,  that  a  due  humility 
should  take  tlu;  i)lace  of  honor  im  the  list.     For  its  own  sake, 
since  with  it  comes  not  only  a  reverence  for  truth,  but  also  a 
proper  estimation  of  the  difficulties  encountered  in  our  search 
for  it.     More  perhaps  than  any  other  professional  man,  the 
doctor  has  a  curious — shall   I  say  morbid  ? — sensitiveness  to 
(what  he  regards)  personal  error.    In  a  way  this  is  right ;  but 
it  is  too  often  accompanied  by  a  cockmireness  of  opinion  (to  use 
a  Johnsonian  word)  which,  if  encouraged,  leads  to  so  lively  a 
conceit  that  the  mere  suggestion  of  mistake  under  any  circum- 
stances is  regarded  as  a  reflection  on  his  honor,  a  reflection 
equally  resented  whether  of  lay  or  of  professional  origin. 
Start  out  with  the  conviction  that  absolute  truth  is  hard  to 
reach  in  matters  relating  to  our  fellow  creatures,  healthy  or 
diseased,  that  slips  in  observation  are  inevitable  even  with 
the  best  trained  faculties,  that  errors  in  judgment  must  occur 
in  the  practice  of  an  Art  which  is  largely  the  balancing  of 
probabilities ; — start,  I  say,  with  this  attitude  of  mind,  and 
mistakes  will  be  acknowledged  and  regretted  ;  but  instead  of 
a  slow  process  of  self-deception,  with  ever-increasing  inability 
to  recognize  truth,  you  will  draw  from  your  errors  the  very 
lessons  which  may  enable  you  to  avoid  their  repetition.    <»^ 

And  for  the  sake  of  what  it  brings,  this  Grace  of  Humility 
is  a  precious  gift.  When  to  the  sessions  of  sweet  silent 
thought  you  summon  up  the  remembrance  of  your  own  im- 
perfectious,  the  faults  of  your  brothers  will  seem  less  grievous, 
and  you  will,  to  use  the  quaint  language  of  Sir  Thomas  Browne, 
"allow  one  eye  for  what  is  laudable  in  them."  The  wrang- 
ling and  unseemly  disputes  which  have  too  often  disgrac^ 
our  profession  arise  in  a  great  majority  of  cases,  on  the  one 


20 


Teacher  and  Stwlent. 


hand,  from  tliia  morbid  sonsitlvonorts  to  the  coiifossion  of  error, 
and,  on  the  other,  from  a  hick  of  brotherly  consideration,  and 
a  convenient  forj:;etfiilne.sHof  our  own  failings.  Take  to  heart 
the  words  of  the  how  of  Siratih,  winged  words  to  the  Hcnsitive 
souls  of  the  sons  of  Ksculapins,  "  Admonish  a  friend,  it  tnay 
be  he  has  not  done;  it;  and  if  he  have  done  it,  that  he  do  it 
no  more.  Admonish  thy  friend,  it  may  l)e  he  hath  not  said 
it;  and  if  he  have,  that  he  speak  it  ajijain.  Admonish  a 
friend,  for  many  times  it  is  a  slander,  and  believe  not 
every  tale."  Yes,  many  times  it  is  a  slander  and  believe 
not  every  tale. 
J|(  The  truth  that  lowliness  is  young  ambition's  ladder  is  hard 
to  grasp,  and  when  accepted  harder  to  maintain.  It  is  so  dif- 
ficult to  be  still  amidst  bustle,  to  be  (juiet  amidst  noise;  yet, 
"es  bildet  ein  Talent  sich  in  dcr  Stille  "  alone,  in  the  calm 
life  necessary  to  continuous  work  for  a  high  purpose.  The 
spirit  abroad  at  j)resent  in  this  country  is  not  favorable  to 
this  Teutonic  view,  which  galls  the  qui(!k  apprehension  and 
dampens  the  enthusiasm  of  the  young  American.  All  the 
same,  it  is  tru^and  irksome  at  first  though  the  discipline  may 
be,  there  will  come  a  time  when  the  very  fetters  in  which  you 
chafed  shall  be  a  strong  defence  and  your  chains  a  robe  of 
glory,    y 

Sitting  in  Lincoln  Cathedral  and  gazing  at  one  of  the 
loveliest  of  human  works,  as  the  Angel  Choir  has  been 
described,  there  arose  within  me,  obliterating  for  the  moment 
the  thousand  heraldries  and  twilight  saints  and  dim  emblazon- 
ings,  a  strong  sense  of  reverence  for  the  minds  which  had  con- 
ceived and  the  hands  which  had  executed  such  fhinL';s  of 
beauty.  What  manner  of  men  were  they  who  could,  'u  (Imsb 
(to  us)  dark  days,  build  such  transcendent  raonumi^nts  t  W  liat 
was  the  secret  of  their  art  ?  By  what  spirit  were  they  moved? 
Absorbed  in  thought  I  did  not  hear  the  beginning  of  the 
music,  and  then  as  a  response  to  ray  reverie  and  arousing  me 
from  JT,  ^crxjy  out  clear  the  voice  of  the  boy  leading  the  anti- 


Tench  fr  and  FHudmt. 


SI 


phon  "TImt  thy  power,  thy  glory  and  mightinoas  of  thy 
kingdom  might  l)e  known  nnto  men."  Here  wns  the  answer. 
Moving  in  a  world  not  realized  thefle  men  sought,  however 
feebly,  to  express  in  glorious  structures  their  conception  of 
the  beauty  of  holiness,  and  these  works,  our  wonder,  are  but 
the  outward  and  visible  signs  of  the  ideals  which  animated 
them. 

Practically  to  us  in  very  different  days  life  ofTers  the  same 
problems,  l)ut  the  conditions  liavo  changed,  and,  as  happened 
before  in  the  world's  history,  great  material  prosperity  has 
weakened  the  influence  of  ideals,  and  blurred  the  eternal 
difference  between  means  and  end.  Still,  the  ideal  State,  the 
ideal  Life,  the  ideal  Church — what  they  are  and  how  best  to 
realize  them — such  dreams  continue  to  haunt  the  minds  of 
men,  and  who  can  doubt  that  their  contem|)lation  immensely 
fosters  the  upward  progress  of  our  race  ?  We,  too,  as  a  pro- 
fession, have  cherished  standa»*d3,  some  of  which,  in  words 
sadly  disproportionate  to  my  subject,  I  have  attempted  to 
portray. 

My  message  is  chiefly  to  you,  Students  of  Medicine,  since 
with  the  ideals  entertained  now  your  future  is  indissolubly 
bound.  The  choice  lies  open,  the  paths  are  plain  before  you. 
Always  seek  your  own  interests,  make  of  a  high  and  sacred 
calling  a  sordid  business,  regard  your  fellow  creatures  as  so 
many  tools  of  trade,  and  if  riches  are  your  heart's  desire  they 
may  be  yours ;  but  you  will  have  bartered  away  the  birth- 
right of  a  noble  heritage,  traduced  the  well-deserved  title  of 
the  physician  as  the  Friend  of  Man,  and  falsified  the  best 
traditions  of  an  ancient  and  honorable  Guild.  On  the  other 
hand  I  have  tried  to  indicate  some  of  the  ideals  which  you 
may  reasonably  cherish.  No  matter  though  they  are  para- 
doxical in  comparison  with  the  ordinary  conditions  in  which 
you  work,  they  will  have,  if  encouraged,  an  ennobling  influ- 
ence, even  if  it  be  for  you  only  to  say  with  Rabbi  Ben  Ezra, 
"  what  I  aspired  to  be  and  was  not,  comforts  me."  And 
though   this  course  does  not  necessarily  bring  position   or 


22 


Teacher  and  Student. 


renown,  consistently  followed  it  will  at  any  rate  give  to  yonr 
youth  an  exhilarating  zeal  and  a  cheerful. less  which  will 
enable  you  to  surmount  all  obstacles — to  your  maturity  a 
serene  judgment  of  men  and  things,  and  that  broad  charity 
without  which  all  else  is  naught — to  your  old  age  that  greatest 
of  all  blessings,  peace  of  mind,  a  realization,  maybe,  of  the 
prayer  of  Socrates  for  beauty  in  the  inward  soui  and  for 
unity  of  the  outer  and  the  inner  man ;  a  fulfilnent,  perhaps, 
of  the  promise  of  St.  Bernard,  "  pfix  sine  or  mine,  pax  sine  tur- 
bine, pax  sine  rixa." 


